BACKGROUND: Post-herpetic neuralgia is the most serious one of herpes zoster complications and its incidence becomes higher as the age of the patient increases. Nevertheless, besides considering the age and onset time of treatment, there is no more objective factor estimating the prognosis of post- herpetic neuralgia. OBJECTIVE: The aim of this study is to understand the progression of herpes zoster and estimate the prognosis of post-herpetic neuralgia by practicing electrodiagnostic tests to patients with herpes zoster. METHODS: We evaluated the pain scales in 26 patients with herpes zoster on the first visit and 2 months later. We also performed electrodiagnostic tests, more objective and reproducible methods, including somatosensory evoked potentials and motor nerve conduction studies on both the involved and uninvolved sites of 32 lesions in 26 patients with herpes zoster, and then compared the results with the change of pain scales. RESULTS: 1. The pain category scale and visual analogue scale on the second examination were significantly decreased compared with those on the first examination (P<0.05). 2. Latencies of intercostal somatosensory evoked potentials recorded on scalp and spine were significantly delayed in involved sides compared with those in uninvolved sides (P<0.05). 3. In the latencies and conduction velocities of motor nerve conduction studies, no significant differences were seen between involved sides and uninvolved sides. 4. On the second examinataion, latency differences of somatosensory evoked potentials were significantly improved compared with those on the first examination (P<0.05). 5. Among the various somatosensory evoked potentials parameters, P1 latency difference of cortical somatosensory evoked potentials between involved and uninvolved sides correlated significantly with pain category scale ard visual analogue scale on second examination (r=0.48, P<0.05; r =0.51, P<0.05, respectively). N1 latency difference of spinal somatosensory evoked potentials between involved and uninvolved sides correlated significantly with a visual analoge scale on the first examination and pain category scale on the second examination (r=0.61, P<0.05; r=0.78, P<0.05, respectively). CONCLUSION: Intercostal somatosensory evoked potentials can be a useful and reliable technique to predict the development and severity of post-herpetic neuralgia.
Evoked Potentials, Somatosensory ; Herpes Zoster* ; Humans ; Incidence ; Neural Conduction ; Neuralgia* ; Prognosis ; Scalp ; Spine ; Weights and Measures

Thyrotoxicosis (thyroid crisis) is a known cause of sudden death; however, only a few cases of death resulting from thyrotoxicosis have been reported. Histopathologic examination and postmortem thyroid function tests may be helpful in postmortem diagnosis, but their usefulness seems to be limited. We report three autopsy cases associated with thyrotoxicosis.
Autopsy ; Death, Sudden ; Thyroid Crisis ; Thyroid Function Tests ; Thyrotoxicosis

Core decompression is still widely used in avascular necrosis of the femoral head but the results are unpredictable and the indications are not settled yet. The reparative process of the decompressed femoral head is poorly understood. Seven cases in 5 patients were undertaken THRA following failed decompression and these were studied for the radiological and pathological changes of the core tracts. The lesions of failed cases were involved more than 1/3 of femoral head on MRI and all cases were stage II A or B. The extent of the necrotic area in MRI was enlarged with crack, sclerosis and sometimes gas collection. Depression of the subchondral plates were also observed. Capillary ingrowth or neovascularization was not found at all and there were only fibrosis, inflammatory response and foreign body reactions.
Capillaries ; Decompression* ; Depression ; Fibrosis ; Foreign Bodies ; Head* ; Humans ; Magnetic Resonance Imaging ; Necrosis* ; Sclerosis

PURPOSE: The objective of this study was to survey potential candidates for bariatric/metabolic surgery for procedure preferences. METHODS: Questions asked were divided into 5 categories: (1) demographic and anthropometric data, comorbidities, and favored surgery; (2) awareness of safety, effectiveness, and complications of each type of surgery; (3) discordances in opinion between self-selected and medically recommended procedures; and (4, 5) reasons for/against particular surgery. RESULTS: From 1 October to 15 November 2018, 104 respondents adequately responded and were included in the analysis. The number (%) of female respondents was 79 (76.0%). The number (%) of respondents by decade was 17 (16.3%) in their 20s, 65 (62.5%) in their 30s, 19 (18.3%) in their 40s, and 3 (2.9%) in their 60s, respectively. Mean body mass index was 37.1 ± 6.3 kg/m2. Comorbidities were type 2 diabetes in 34 (32.7%) and hypertension in 35 (33.7%). The most favored procedure was sleeve gastrectomy (SG) in 78 (75.0%), adjustable gastric band (AGB) surgery in 12 (11.5%), Roux-en-Y gastric bypass (RYGB) in 6 (5.8%), and gastric plication (GP) in 8 (7.7%). Major reasons for choosing procedures were; “adjustable” for AGB, “stomach sparing” for GP, “excellent weight loss” for SG, and “comorbidity resolution” in RYGB. CONCLUSION Candidates for bariatric/metabolic surgery favored SG followed by AGB, GP, and RYGB, and their choices were compatible with current evidence-based clinical practice.

The purpose of this study was to identify the consciousness of biomedical ethics and attitudes toward human tissue donation and transplantation among participants and non-participants in the anatomy camp program. Data collection is made from one hundred and eighty-two students who were enrolled in one university nursing department, in B metropolitan city. Ninety-six students participated in the anatomy camp program, while eighty-six students did not participate in the anatomy camp program. The total mean scores of consciousness of biomedical ethics between participants (2.03/4) and non-participants (1.96/4) were significantly different (t=2.217, p≤.028). And the total mean scores of attitudes toward human tissue donation and transplantation between participants (3.49/5) and non-participants (3.31/5) were significantly different (t=4.579, p≤.000). There were statistically significant differences between two groups in sub-categories of consciousness of biomedical ethics: organ transplantation, artificial insemination.
Bioethics* ; Consciousness* ; Data Collection ; Humans ; Humans* ; Insemination, Artificial ; Nursing* ; Organ Transplantation ; Students, Nursing* ; Tissue and Organ Procurement* ; Transplants

OBJECTIVES: To determine changes in the incidence and pattern of eclampsia in Il Sin Christian Hospital over a 46-year period. METHODS: Information was collected from medical records of the 1910 eclamptic patients among 233,613 deliveries in Il Sin Christian Hospital from Jan. 1 1953 to Dec. 31 1998. Incidence, presentation, and management of eclampsia were reviewed retrospectively, and maternal mortality rate and perinatal mortality rate were calculated. Statistical analysis was done by Chi-squared and Fisher's exact test through two by two tables looking at relative changes between each study period. RESULTS: The overall incidence of eclampsia was 81.8 per 10,000 deliveries. The incidence of eclampsia had increased from 137.3/10,000 in 1953-1962 to 278.4/10,000 in 1963-1972, but the rate had reduced to 6.5/10,000 in 1993-1998. There was a statistically significant fall in the rate of eclampsia every decade between 1973 and 1992, but there has been steady decrease in the last study period. Convulsion occurred antepartum in 54% of patients, intrapartum in 29% and postpartum in 17%. With the reduction in the proportion of antepartum eclampsia, there has been a relative increase in that of intrapartum and postpartum eclampsia. Maternal death occurred in 59 cases among eclampsia, and maternal mortality rate was 3.1%. Maternal mortality rate had significantly decresed from 11.1% in 1953-1962 to 3.8% in 1963-1972, and there has been no maternal death from eclampsia since 1986. Postpartum eclampsia had increased death risk compared with antepartum or intrapartum eclampsia. There were 280 cases of perinatal death and overall perinatal mortality rate was 144.1 per 1000 deliveries. There was a significant decrease in the rate from 243.2/1000 in 1953-1962 to 141.5/1000 in 1963-1972, but the rate has risen steadily since 1983. CONCLUSIONS: With the improvement in antenatal care and management of eclampsia, the incidence of eclampsia and its associated maternal mortality has decreased over the last 46 years. But eclampsia still remains a significant complication of pregnancy with high maternal and perinatal mortality.
Eclampsia* ; Female ; Humans ; Incidence ; Maternal Death ; Maternal Mortality ; Medical Records ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Retrospective Studies ; Seizures

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

Gastric surgery is one of the most frequently performed operations in Korea. Retroanastomotic hernia is a rare complication ingastric surgery. We experienced this hernia and herein report it with a review of the literature. A 69-year-old male patient suffered from periumbilical pain for 3 days. Positive physical findings were tenderness around the umbilicus and decreased bowel sound. Simple abdominal findings revealed a mechanical obstruction. This patient had a history of gastrectomy 13 years prior to admission. At operation field, we were able to find the defect consisting of the transverse mesocolon, stomach, jejunum and retroperituneum. In Korea, since its first report by Petersen, only a few reports about this hernia have been reported. After increased incidence of operations for morbid obesity, reports on retroanstomotic hernia have increased.
Aged ; Gastrectomy ; Hernia ; Humans ; Incidence ; Jejunum ; Korea ; Male ; Mesocolon ; Obesity, Morbid ; Stomach ; Umbilicus

STUDY DESIGN: A retrospective analysis of the patients who had cauda equina syndrome caused by a herniated lumbar disc. OBJECTIVES: To assess the clinical debates concerning the diagnosis, treatment, and results of treatment. SUMMARY OF LITERATURE REVIEW: This syndrome has been considered as an absolute indication of surgical treatment in the herniated lumbar disc and poor prognosis after surgery were reported. Although there are debates on the timing of surgery, early recognition early surgical treatment are recommended for a better results of treatment. MATERIALS AND METHODS: 23 consecutive patients having a cauda equina syndrome caused by herniated lumbar disc were reviewed retrospectively. They were 14 males and 9 females having ages of 41.6 in average. The incidence of this syndrome was 3.8% of the patients who had surgical treatment of herniated lumbar disc. RESULTS: All patients had bladder dysfunction in addition to the low back pain and radicular pain in the leg, but five patient did not recognize their urinary retention which were shaded by severe leg pain. A surgical treatment were performed for all patients at 6.8 days in average after onset of the bladder dysfunction. At follow-up of 3 years and 3 months in average after surgery, 20 patients(86.9%) had satisfactory resolution of the low back pain and leg pain, and all patients had complete recovery of motor weakness except one patients who had residual foot drop. Bladder function recovered satisfactorily in 18 patients (78.3%), but 4 patients had some difficulty of urination and one patient needed a sphinterotomy for urination. CONCLUSIONS: The cauda equine syndrome in herniated lumbar disc was often not recognized early and a poor result of treatment was not rare, particularly in the patients who had acute onset and severe bladder dysfunction. So, early diagnosis and active surgical treatment are recommended for a better results of treatment.
Cauda Equina* ; Diagnosis ; Early Diagnosis ; Female ; Follow-Up Studies ; Foot ; Humans ; Incidence ; Leg ; Low Back Pain ; Male ; Polyradiculopathy* ; Prognosis ; Retrospective Studies ; Urinary Bladder ; Urinary Retention ; Urination

Although many methods have been developed to correct the aging process of the head and neck, the correction of nasolabial folds still remains a difficult area. The difficulty of correcting nasolabial fold is due to the anatomical location and the difference of aging process. From March 2000 to February 2001, the authors operated on 10 aging face patients using face lift with SMAS and FAME(Finger-assisted malar fat pad elevation) technique. The authors repositioned the SMAS-platysma flap posterosuperiorly and used finger dissection of the malar fat pad enabling a 3-dimensional correction and repositioning of the fat pad without detachment of the zygomatic ligament. The finger dissection of the malar fat pad attached to the skin enables a more anatomical correction of the malar fat pad with a more natural looking layer and longer lasting results in addition to decreased hematoma, edema and postoperative pain compared to previous methods.
Adipose Tissue ; Aging ; Edema ; Fingers ; Head ; Hematoma ; Humans ; Ligaments ; Nasolabial Fold ; Neck ; Pain, Postoperative ; Rhytidoplasty* ; Skin